人乳头瘤病毒（HPV）感染与阴道微生态的相关性研究

目的 探讨人乳头瘤病毒（HPV）与阴道微生态的相关性。为阴道微生态失衡患者及时纠正阴道菌群的紊乱,避免或减少其感染HPV及宫颈癌的防治提供科学依据。方法 选取2015年5月－2016年6月在我院妇科门诊就诊的1412例患者进行HPV、阴道微生态检测。分析阴道菌群及微生态结果与HPV感染的相关性。结果 1412例患者中HPV阳性有542例,占38.39%,HPV阴性有870例,占61.61%。分别以革兰阳性大杆菌、革兰阴性短杆菌、革兰阳性杆菌、革兰阳性球菌/链球菌为优势菌及无优势菌的患者,HPV感染率分别为34.45%、49.16%、33.33%、39.28%、38.70%,OR值分别为0.654（0.526-0.815）、1.818（1.426-2.318）、1.426（0.515-1.209）、1.039（0.483-2.236）、1.014（0.601-1.711）。细菌性阴道病（BV）、滴虫性阴道炎（TV）、需氧性阴道炎（AV）、外阴阴道假丝酵母菌病（VVC）的HPV感染阳性率分别为27.49%、1.29%、7.38%、12.54%,P值分别为0.000、0.754、0.570、0.318。结论 HPV感染与革兰阴性短杆菌及BV显著相关,革兰阳性大杆菌与HPV的感染呈负相关,菌群紊乱及BV可能增加HPV感染的风险。     

Advancement in Deep Learning Methods for Diagnosis and Prognosis of Cervical Cancer

Cervical cancer is the leading cause of death in women, mainly in developing countries, including India. Recent advancements in technologies could allow for more rapid, cost-effective, and sensitive screening and treatment measures for cervical cancer. To this end, deep learning-based methods have received importance for classifying cervical cancer patients into different risk groups. Furthermore, deep learning models are now available to study the progression and treatment of cancerous cervical conditions. Undoubtedly, deep learning methods can enhance our knowledge toward a better understanding of cervical cancer progression. However, it is essential to thoroughly validate the deep learning-based models before they can be implicated in everyday clinical practice. This work reviews recent development in deep learning approaches employed in cervical cancer diagnosis and prognosis. Further, we provide an overview of recent methods and databases leveraging these new approaches for cervical cancer risk prediction and patient outcomes. Finally, we conclude the state-of-the-art approaches for future research opportunities in this domain.     

The use of p63 as an effective immunomarker in the diagnosis of pulmonary squamous cell carcinomas on de-stained bronchial lavage cytological smears

M. Uke, B. Rekhi, D. Ajit and N. A. Jambhekar
The use of p63 as an effective immunomarker in the diagnosis of pulmonary squamous cell carcinomas on de‐stained bronchial lavage cytological smears Objectives: A diagnosis in pulmonary onco‐cytopathology primarily necessitates distinguishing small cell carcinoma (SCLC) from non‐small cell carcinoma (NSCLC), which includes squamous cell carcinoma and adenocarcinoma. Lately, p63 antibody has been used for distinguishing squamous cell carcinoma from SCLC and adenocarcinoma. We present an analysis of p63 expression in cytological smears from 100 bronchial lavage specimens comprising 51 cases of SCLC and 49 cases of NSCLC. Methods: A single Papanicolaou‐stained conventional smear was de‐stained and re‐fixed with cold acetone and methanol for immunocytochemical staining with p63 antibody. Staining results were graded as 0 (nil), 1+ (focal), 2+ (moderate, diffuse) and 3+ (strong, diffuse). Results: Out of 100 cases, 21 were cytologically diagnosed as squamous cell carcinoma. Twenty of these showed 2+ or 3+ p63 positivity, whereas one, which was adenocarcinoma on histology, showed 1+ staining. Of seven cases cytologically diagnosed as adenocarcinoma, six showed no p63 staining, whereas one, which was squamous cell carcinoma on histology, showed 1+ staining. All 48 cases cytologically diagnosed as SCLC were confirmed as such on histology and showed no p63 staining. Four cases were cytologically designated as poorly differentiated carcinomas, of which three showed no p63 staining and one showed 3+ staining. The former three were found to be SCLC on histology while the latter was squamous cell carcinoma. The remaining 20 cases were cytologically designated as NSCLC. Of these, eight showed no p63 staining, whereas 10 showed 1+ and two showed 2+ staining. The former eight were adenocarcinoma on histology and the latter two were squamous cell carcinoma. The 10 cases that showed 1+ p63 staining were adenocarcinomas (n = 5), squamous cell carcinoma (n = 4) and NSCLC, not otherwise specified (n = 1). Positive staining was seen in normal basal cells, which acted as an internal control. Overall sensitivity of p63 for squamous cell carcinoma was 100% and specificity was 90.4%. Conclusions: p63 immunostaining on processed cytology smears can be used to help identify squamous cell carcinoma. Its diffuse expression was specific for squamous cell carcinoma while focal staining was also seen in adenocarcinoma.     

The fine needle aspiration appearances of Kikuchi's lymphadenitis

Objective:  To describe the fine needle aspiration cytological appearances of Kikuchi's lymphadenitis.
Methods:  Cytological review with histological correlation of all cases of Kikuchi's disease (KD) in which there had been an antecedent fine needle aspirate of the involved lymph node prior to lymph node excision between 2001 and 2006.
Results:  Twelve cases of KD were identified in which cytological and histological material was available. In eight cases the original prospective diagnosis of necrotizing non-granulomatous lymphadenitis consistent with KD had been suggested on the lymph node aspirate. Review of these cytological samples identified abundant extra- and intracellular apoptotic debris – the latter embedded in the cytoplasm of crescentic and phagocytic macrophages, set in a background reactive lymphoid population. Three of 12 cases were initially reported as in keeping with nonspecific reactive lymphadenopathy. Review identified intracellular apoptotic debris but no conspicuous extracellular nuclear debris. One case had originally been reported as possible non-Hodgkin's lymphoma. Histological review of the excised lymph nodes in all 12 cases showed the classical appearances of KD.
Conclusion:  The accurate diagnosis of KD on fine needle aspiration is possible given correct clinical data, an adequately sampled and well-prepared specimen in which the characteristic intra- and extracellular apoptotic nuclear debris with admixed crescentic macrophages are identified on a reactive lymphoid background.     

Analysis of the performance of 100% rapid review using an average time of 1 and 2 minutes according to the quality of cervical cytology specimens

E. J. C. Manrique, N. L. A. Souza, S. B. N. Tavares, Z. B. P. Albuquerque, L. C. Zeferino and R. G. Amaral Analysis of the performance of 100% rapid review using an average time of 1 and 2 minutes according to the quality of cervical cytology specimens Objectives: To compare the performance of the 100% rapid review method carried out in a mean time of either 1 or 2 minutes according to cytological final result, and to assess whether the presence of obscuring factors in cervical smear samples affects the frequency of false‐negative results. Methods: A total of 5 235 smears classified as negative (93.0%) or unsatisfactory (2.1%) at routine screening were submitted to 100% rapid review using mean times of 1 and 2 minutes. Results: Of the 5 235 smears submitted to 1‐minute rapid review, 88 were considered suspect and of these, 45 were confirmed as abnormal in the cytological final result. When the time used was 2 minutes, 67 smears were considered suspect, 44 of which were confirmed as abnormal. Sensitivity and specificity were similar in the 1‐ and 2‐minute reviews. In smears in which samples were satisfactory and had no obscuring factors, sensitivity and specificity were 64.2% and 98.9% and 61.5% and 99.5% for the 1‐ and 2‐minute reviews, respectively. In comparison, in smears in which the sample was satisfactory for analysis but partially obscured (50–75%), sensitivity and specificity were 64.7% and 99.9% and 70.6% and 99.8% for the 1‐ and 2‐minute reviews, respectively. Conclusions: The method of rapid review of 100% showed no difference in the detection of false‐negative results using the time of 1 or 2 minutes. The quality of the sample did not influence the detection of false‐negatives.